Device and method for treating a vessel

ABSTRACT

A device and method for treating bodily diseases and/or conditions, for example, varicose veins, tumors and aneutisms including for example insertion of a blocking device toward a target destination using a catheter and delivery of sclerosing or other agents to the vessel while maintaining minimal, for example zero pressure in the treatment area. The blocking device may prevent treatment materials, embolisms, debris etc., from entering the upstream section of vessel. The blocking device may include, for example, a cap or other concave shape and may be expandable or extendible towards the vessel walls.

FIELD OF THE INVENTION

The present invention relates to methods and devices to enable blockage,occlusion and/or treatment of vessels such as blood vessels.Specifically, embodiments of the present invention relate to devices andmethods that may block selected segments of veins or arteries.

BACKGROUND OF THE INVENTION

Various bodily diseases and/or conditions, including, for example,tumors, aneurisms and varicose vein expansion, may be caused bymalfunction or other problems associated with the veins or arteries thatsupply or remove blood to/from the treatment areas For example, thevenous system of the lower extremities includes the superficial (greaterand lesser saphenous veins) and deep system (popliteal and femoralveins). These two parallel systems are interconnected via perforatorveins. One-way valves are present at the junctions between thebifurcation point of the deep and superficial system, at thesaphenofemoral and the saphenopopliteal junctions.

Larger varicose veins, e.g., tortuous veins measuring between 2 mm and 2cm in diameter; and protruding above the surface of the skin, aretypically related to valve incompetence either at the saphenofemoral orsaphenopopliteal junction. As the venous pressure in the deep system isgenerally greater than that of the superficial system, valveincompetence leads to increased hydrostatic pressure transmitted to theunsupported superficial vein system, ultimately resulting invaricosities. Clusters of varicosities may appear at the site ofperforating vessels, such as the perforating veins of Hunter and Dodd,located in the mid and distal thigh, respectively. This pattern ofvaricosity is typically associated with incompetence at thesaphenofemoral junction.

In some instances, the valvular incompetence may be isolated to aperforator vein, such as the Boyd perforating vein located in theanteromedial calf. These varicosities are often not associated withsaphenous vein incompetence since the perforating veins in the lowerpart of the leg do not communicate directly with the saphenous vein.Although many varicose veins are asymptomatic, symptoms includingitching, heaviness, and pain may occur. In addition, varicose veins maybe complicated by peripheral edema due to venous insufficiency,hemorrhage, thrombophlebitis, venous ulceration, and chronic skinchanges.

Varicose veins are a common condition. In adult western populationsvisible varicose veins are present in 20-25% of women and 10-15% of men.In most persons, varicose veins do not cause symptoms other than poorcosmetics. Varicose vein surgery is one of the most commonly performedcosmetic procedures in the United States.

Most varicose veins do not require medical treatment (Tapley, et al.2003). In some cases, however, the circulation may be hindered enough tocause swelling of the foot and ankle, discomfort, a tingling sensation,or a feeling of heaviness. For most people with varicose veins, wearingspecially fitted elastic stockings is all that is needed. The stockingsshould be carefully fitted to the individual, providing the mostpressure in the lowest part of the leg. Exercise such as walking orcycling also helps promote better circulation from the lower part of thebody. Symptoms often decrease when the legs are elevated periodically,and when prolonged standing is avoided. Varicose veins can usually betreated with non-surgical measures.

When conservative treatment measures fail, additional treatment optionstypically focus first on identifying and correcting the site of reflux,and second on redirecting venous flow through veins with intact valves.Surgical treatment of varicosities may include controlling the mostproximal point of reflux, typically at the saphenofemoral junction, asidentified by preoperative Doppler ultrasonography. Surgical ligationand division of the saphenofemoral or saphenopopliteal junction isperformed to treat the valvular incompetence. Another surgical treatmentincludes removal of the refluxing greater and/or lesser saphenous veinfrom the circulation. The most typical strategy for isolation is veinstripping, which is generally preceded by vein ligation and division. Afurther surgical treatment includes removal of the varicose tributaries.Strategies for removal include stab avulsion or injection sclerotherapy,either at the time of the initial treatment, or subsequently.

Over the years various different minimally invasive alternatives toligation and stripping have been investigated, including sclerotherapy,endoluminal radiofrequency ablation and laser ablation. The objective ofsclerotherapy is generally to destroy the endothelium of the targetvessel by injecting an irritant solution (for example a detergent,osmotic solution, or a chemical irritant), ultimately resulting in thecomplete obliteration of the vessel. Too little destruction may lead tothrombosis without fibrosis and ultimate recanalization. Too muchdestruction may lead to vascular dehiscence. The success of thetreatment may depend on accurate injection of the vessel, an adequateinjectant volume and concentration of sclerosant, and post-procedurecompression. Compression theoretically results in direct apposition ofthe treated vein walls to provide more effective fibrosis and maydecrease the extent of the thrombosis formation. Therefore, due totechnical limitations, larger veins and very tortuous veins may not begood candidates for sclerotherapy.

While sclerotherapy is an accepted and effective treatment oftelangiectatic vessels, it has also been used in the treatment ofvaricose tributaries without prior ligation, with or without veinstripping. This application of sclerotherapy creates issues regardingits effectiveness in the absence of the control of the point of refluxand isolation of the refluxing saphenous vein. In addition, when thesclerosant is injected into the greater or lesser saphenous vein,sclerotherapy has been investigated as a minimally invasive alternativeto vein stripping, either with or without ligation. Since the saphenousvein is not visible with the naked eye, injection is typically guided byultrasonography, and the combined procedure may be referred to as“echosclerotherapy.” Since the greater saphenous vein is larger anddeeper than telangiectatic dermal veins, sclerotherapy of this veinraises issues regarding appropriate volume and concentration of thesclerosant and the ability to provide adequate post-procedurecompression. Moreover, the use of sclerotherapy, as opposed to thephysical removal of the vein with stripping, raises the issue ofrecurrence due to recanalization.

McDonagh, et al. (2002, 2003) has reported on the effectiveness ofultrasound-guided foam sclerotherapy (comprehensive objective mapping,precise image-guided injection, antireflux positioning and sequentialsclerotherapy (COMPASS) technique) in the treatment persons withvaricosities of the greater saphenous vein with saphenous vein reflux.Published studies of the COMPASS technique involve relatively short-termfollow up. Study subjects were followed for three years, and for onlytwo years after completion of a series of repeat sclerotherapyinjections that were administered over one year. In addition, thesestudies do not include a comparable group of subjects treated withsurgery, which has been the primary method of treating incompetent longsaphenous veins. Thus, definitive conclusions cannot be made about thedurability of results of the COMPASS technique or its effectivenesscompared with surgery for treatment of greater saphenous veinvaricosities and saphenofemoral incompetence. In addition, publishedstudies of the COMPASS technique come from a single group ofinvestigators.

Published long-term randomized controlled clinical studies havedemonstrated that surgery plus sclerotherapy is more effective thansurgery alone for treatment of varicosities associated with incompetenceof the saphenofemoral junction. Belcaro, et al. (2003) reported on theresults from the Venous Disease International Control (VEDICO) trial,the first long-term randomized controlled clinical trial of foamsclerotherapy. The VEDICO trial involved 749 patients with varicoseveins and saphenous vein incompetence who were randomly treated by sixdifferent approaches: standard sclerotherapy, high-dose sclerotherapy,surgical ligation, stab avulsion, foam sclerotherapy, and combinedsurgery (ligation or stab avulsion) and high dose sclerotherapy At 10years, the occurrence of new veins was 56% for standard sclerotherapy,51% for foam sclerotherapy, 49% for high-dose sclerotherapy, 41% forstab avulsion, 38% for ligation, and 27% for combined surgery andsclerotherapy.

Belcaro, et al. (2000) reported on the results of a randomizedcontrolled clinical study comparing ultrasound-guided sclerotherapy withsurgery alone or surgery combined with sclerotherapy in 96 patients withvaricose veins and superficial venous incompetence. Although allapproaches were reported to be effective in controlling the progressionof venous incompetence, surgery appeared to be the most effective methodon a long-term basis, and that surgery combined with sclerotherapy maybe more effective than surgery alone. After 10 years follow up, noincompetence of the saphenofemoral junction was observed in both groupsassigned to surgery, compared to 18.8 percent of limbs of subjectsassigned to ultrasound-guided sclerotherapy. Of limbs treated withultrasound-guided sclerotherapy, 43.8% of the distal venous systems wereincompetent, compared to 36% of limbs of subjects treated with surgeryalone, and 16 1% of limbs of subjects treated with surgery plussclerotherapy.

In recent years, new methods such as ES (endovascula sclerotherapy) andfoam sclerotherapy (using ultrasound guidance) have been developed andproposed to improve the safety and efficacy of sclerotherapy for varioustypes of varicose veins. Evidence about these new techniques fortreating patients with incompetence of the long saphenous vein islimited, and the place of sclerotherapy as the first treatment forlarger varicose veins (saphenous or non-saphenous) remainscontroversial.

Endoluminal radiofrequency ablation and laser ablation (e.g. VNUS®Closure™ System, Dornier Diode (Medilas D) and Diomed 810 nm surgicallaser and EVLI (endovenous laser therapy)) have been investigated asminimally invasive alternatives to vein ligation and stripping. Bothradiofrequency energy and laser therapy are similarly designed to damagethe intimal wall of the vessel, resulting in fibrosis and ultimatelyoblitetation of a long segment of the vein. Radiofrequency ablation isgenerally performed by means of a specially designed catheter insertedthrough a small incision in the distal medial thigh to within 1-2 cm ofthe saphenofemoral junction. High frequency radio waves (200-300 kHz)are delivered through the catheter electrode and cause direct heating ofthe vessel wall, causing the vein to collapse. The catheter is slowlywithdrawn, closing the vein. Laser ablation is performed similarly. Inthe case of endoluminal laser therapy, a bare tipped laser fiber isintroduced into the greater saphenous vein under ultrasound guidance;the laser is activated and slowly removed along the course of thesaphenous vein.

Such catheters may generally treat veins with diameters that range from2 to 12 mm. Each catheter may have a microthermocouple to monitor veinwall temperature. In practice, the catheter with its electrodessheathed, is passed either prograde or retrograde through a venipunctureor through direct surgical exposure of the saphenous vein. The catheterposition may be confirmed by ultrasound imaging, and exsanguination ofthe vein may be accomplished by external elastic wrapping (Esmarchbandaging) or large-volume, very dilute local anesthesia (tumescenttechnique).

Perhaps the most serious complication of varicose vein surgery, or othervein blockage surgery, is deep venous thrombosis with or withoutpulmonary embolization. In a number of early reports of varicose veinsurgery and minimally invasive endoluminal therapy, the incidence ofpulmonary embolization has ranged from 0.4% to 1. A less serious buttroublesome complication is dysfunction in the territory of the greatersaphenous nerve. This was found in 12.5% of limbs treated by endoluminaltherapy

Subfascial endoscopic perforator vein surgery (SEPS) is a minimallyinvasive endoscopic procedure that eliminates the need for a largeincision in the leg. It has been explored as an alternative to thetraditional open surgical treatment of chronic venous insufficiency. Theaim of the procedure is to interrupt incompetent medial calf perforatingveins to reduce venous reflux and decrease ambulatory venoushypertension in critical areas above the ankle where venous ulcers mostfrequently develop. Kaha and Gloviczki (2002) stated that availableevidence confirmed the superiority of SEPS over open perforatorligation, but do not address its role in the surgical treatment ofadvanced chronic venous insufficiency (CVI) and venous ulceration.Ablation of superficial reflux by high ligation and stripping of thegreater saphenous vein with avulsion of branch varicosities isconcomitantly performed in the majority of patients undergoing SEPS: Theclinical and hemodynamic improvements attributable to SEPS thus aredifficult to ascertain. As with open perforator ligation, clinical andhemodynamic results are better in patients with primary valvularincompetence (PVI) than in those with the post-thrombotic (PT) syndrome

Contraindications for SEPS include associated arterial occlusivedisease, infected ulcer, a non-ambulatory patient, and a medicallyhigh-risk patient. Diabetes, renal failure, liver failure, morbidobesity, ulcers in patients with rheumatoid arthritis, or scleroderma,and presence of deep vein obstruction at the level of the popliteal veinor higher on pre-operative imaging are relative contraindications.Patients with extensive skin changes, circumferential large ulcers,recent deep vein thrombosis, severe lymphedema, or large legs may not besuitable candidates (Kalra and Gloviczki, 2002)

BRIEF DESCRIPTION OF THE DRAWINGS

The principles and operation of the system, apparatus, and methodaccording to the present invention may be better understood withreference to the drawings, and the following description, it beingunderstood that these drawings are given for illustrative purposes onlyand are not meant to be limiting, wherein:

FIG. 1 is a schematic illustration of a vessel closure device in abifurcated vessel, according to an embodiment of the present invention;

FIG. 2 is a schematic illustration of a catheter delivery of a vesselblocking device, according to an embodiment of the present invention;

FIGS. 3A-3E are schematic illustrations of vessel blocking devices withdifferent types of anchoring mechanisms, according to some embodimentsof the present invention;

FIGS. 4A-4E are schematic illustrations of anchoring mechanisms onrespective substrates, according to some embodiments of the presentinvention;

FIGS. 5A and 5B are schematic illustrations depicting the anchoring ofrespective vessel blocking devices into a vessel wall, using an internalvacuum, according to an embodiment of the present invention

FIG. 5C is a flow chart describing a method for blocking a vessel,according to an embodiment of the present invention;

FIGS. 6A-6C are schematic illustrations depicting anchoring of vesselblocking devices into a vessel wall, according to some embodiments ofthe present invention;

FIG. 6D is a flow chart describing a method for blocking a vessel,according to another embodiment of the present invention;

FIG. 7A is a schematic illustration depicting the anchoring of a vesselblocking device into a vessel wall, according to an embodiment of thepresent invention;

FIG. 7B is a flow chart describing a method for blocking a vessel,according to an embodiment of the present invention;

FIG. 7C is a schematic illustration depicting the anchoring of a vesselblocking device into a vessel wall, according to an embodiment of thepresent invention; and

FIG. 8 schematic illustration of a transverse view of an intraluminalvessel occluding stent or blocking device 800 according to an embodimentof the present invention.

It will be appreciated that for simplicity and clarity of illustration,elements shown in the drawings have not necessarily been drawn to scale.For example, the dimensions of some of the elements may be exaggeratedrelative to other elements for clarity. Further, where consideredappropriate, reference numerals may be repeated among the drawings toindicate corresponding or analogous elements throughout the serialviews.

DETAILED DESCRIPTION OF THE INVENTION

The following description is presented to enable one of ordinary skillin the art to make and use the invention as provided in the context of aparticular application and its requirements. Various modifications tothe described embodiments will be apparent to those with skill in theart, and the general principles defined herein may be applied to otherembodiments Therefore, the present invention is not intended to belimited to the particular embodiments shown and described, but is to beaccorded the widest scope consistent with the principles and novelfeatures herein disclosed In other instances, well-known methods,procedures, and components have not been described in detail so as notto obscure the present invention.

Embodiments of the invention may include an intraluminal deviceconfigured to treat complications in vessels, for example bifurcatedvaricose veins or other damaged vessels, lumen, etc., by selectivelyblocking off at least part of a vessel using a typically minimallyinvasive technique. For example, a predetermined region (e.g., thesaphenofemoral region) of a bifurcated vein may be blocked off oroccluded, and treated typically without harming the non-blocked offregion of the vessel. The blocked off section of the vessel may betreated using, for example, ligation, heat and/or sclerosing or othersuitable agents. Other lumens may be occluded or blocked using variousembodiments of the present invention.

Reference is now made to FIG. 1, which schematically illustrates asimplification of part of the human venus system, including a bifurcatedvessel 102. A saphenous vein 106 extends into a femoral vein 104, viasaphenofemoral junction 107. A vessel blocking device 108, as isdescribed in detail below, may be deployed in vessel 102, for example,proximal to the saphenofemoral junction 107, or at other suitablelocation, to block off at least a part of vessel 106. For example, theupstream section of a vein may be blocked off to enable treatment and/ordestruction of the blocked portion and/or upstream section of the vein.

Reference is made to FIG. 2, which schematically illustrates a catheterdelivery of a vessel blocking device, according to an embodiment of thepresent invention. Vessel blocking device 200 may be inserted, forexample, into a target vessel 205 that requires treatment, for example,a bifurcated vessel or an occluded blood segment that is to be blockedand/or otherwise treated. Such insertion of device 200 may beimplemented, for example, using an insertion device such as a catheter210, which may include, for example, a guidewire 230, to help guidedevice 200 to a selected location. Other insertion devices and methodsmay be used. Catheter 210 may include for example a drug dispensingmechanism 215, to enable delivery of a pharmaceutical compound,medication, solution, foam or another suitable agent, such as forexample a sclerosing agent, to a target area, via catheter 210. Catheter210 may include a proximal end (not shown, typically towards or at thecontrol end of the catheter 210) and a distal tip 220. Proximal anddistal when use herein are relative terms, typically relative to thecontrol end or holding end of catheter 210; e.g., proximal is nearer thecontrol or external end. The control end (e.g. the proximal end) may beused for holding and operating catheter 210, for example, by a doctor ora health professional. The distal tip 220 may be located after insertionin proximity to the blocking and/or treatment area. Vessel blockingdevice 200 may include one or more inflatable balloons 240, which may beremotely inflated and/or deflated, for example, by inputting and/orextracting gas and/or liquid via for example an inflation/deflationchannel 225. Other or different channels may be used. Other suitableexpansion or pressure application elements, other than balloons, may beused. Vessel blocking device 200 may include an extendable or expandablecovet or cap 250 that may be extended or expanded so as to block avessel. The term “cap” as used herein may encompass, for example, ablocking device, shield, plug, stopper, choke or other device orapparatus to plug up, block or occlude, either partially or completely,a selected lumen or vessel. Cap 250 may be concave or bowl shaped andmay include a rim 251. Cap 250 may be expandable so that rim 251 mayextends outwards towards vessel walls when, for example, a pressure isprovided inside. For example, balloons 240 may be inflated, therebypressuring cap 250 to extend towards the walls of a vessel 205. Cap 250may be constructed from silicon, plastic, rubber; metal or any othersuitable material or combinations of materials. For example, cap 250 maybe a flexible structure that may be extended, expanded, retracted,shrunk etc. within a vessel or lumen. More than one cap may be used;e.g., caps placed narrow end to narrow end, or wide end to wide end, maybe used.

Vessel blocking device 200 may include a base 260, for example,constructed from stainless steel, rubber, mesh or other suitablematerials, to enable stabilizing of cap 250 in a selected locationand/or permanent or semi-permanent strengthening of vessel blockingdevice 200. Base 260 may be mechanically bonded to a portion of cap 250and/or balloons 240 with, for example, glue, clips, grooves or othersuitable bonding mechanisms. Base 260 may enclose balloons 240, cap 250,or may be alternatively arranged to appropriately support cap 250 and/orballoons 240. Balloons 240 may be disposed between cap 250 and the base260. Base 260 and/or cap 250 may partially surround balloon 250 Vesselblocking device 200 may include an expansion element (e.g., a balloon, aspring, a stent like mechanism, etc.) disposed between cap 250 and base260 to increase in pressure in the inner portion of the cap to cause thecap to expand outwards towards the vessel walls. Base 260 may also becap shaped—e.g., two caps may be connected, either at their narrow endsor wide ends. Base 260 may be for example spherical, elliptical, roundedor flat, or may have other suitable geometrical or non-geometricalshapes to enable strengthening or stabilizing of cap 250 and/or balloons240 in vessel 205. Base 260 may be extended or expanded outwards towardswalls of vessel 205, by, for example, inflation of balloons 240 and/orextension of cap 250. Vessel blocking device 200 may be located at thedistal tip 220 of the insertion device, for example, catheter 210, andcap 250 may be distal to catheter 210 relative to the cap. Balloon 240may be disposed between cap 250 and base 260.

Vessel blocking device 200 may be disconnected from catheter 210 oranother insertion unit and unnecessary elements of vessel blockingdevice 200 and/or other elements from vessel 205 may be removed togetherwith catheter 210 from a body, leaving required elements of vesselblocking device 200 in place in vessel 205. For example, after blockingof a vessel has been inserted or implemented by cap 250 and/or base 260,guidewire 230, balloons 240 and/or other non-required elements may beextracted from a vessel 205, via for example catheter 210. Vesselblocking device 200 may enable a total blockage of vessel 205 to bemaintained, such that, for example, treatments executed in a section ofvessel 205 may be isolated in a selected area defined by cap 250 and/orbase 260 and may thereby prevent treatment materials, embolisms, debrisetc. from entering the upstream section of vessel 205. For example,vessel 205 may be partially or completely blocked by vessel blockingdevice 200 while at least a portion of vessel 205 is treated, forexample, using sclerotherapy and/or ligation or other treatments,thereby preventing embolisms, debris, pharmaceutical agents and/or otherhazardous materials from flowing upstream through vessel 205, forexample, to the brain, heart or other vital organs.

Reference is made to FIGS. 3A and 3B which schematically illustratetypes of anchoring mechanisms of vessel blocking devices according tosome embodiments of the invention. Base 260 may include one or moreanchoring mechanisms 310, for example spikes, hooks or any othersuitable shapes or mechanisms placed on a substrate 320. Anchoringmechanisms 310 may be made of for example medical grade rubber, metal,or other suitable materials, as known in the art, or from other suitablematerials. Anchoring mechanisms 310 may have varying shapes andarrangements, for example, they may be shaped as arrays of straightspikes, angles spikes, twisted spikes etc. Any suitable combination ofspike types, shapes and angles etc. may be used, in any suitablecombination, to enable suitable anchoring of cap 250 to vessel wall 205,Anchoring mechanisms 310 may be located on a single substrate 320 onbase 260, or may be located on a plurality of separate substrates, toenable greater flexibility when base 260 is extended. Other structuresor configurations for anchoring or holding may be used. In someembodiments, specific anchoring mechanisms need not be used. For examplepressure or friction may be used for anchoring.

In some embodiments anchoring mechanisms 310 may be associated withand/or connected to cap 250 and/or base 260, optionally enabling cap 250and base 260, individually and/or in combination to anchor with thewalls of vessel 205.

As can be seen with reference to FIG. 3B, cap 250 may include a pullablemechanism or an attachment mechanism 330, for example, a hook shapedmechanism or other suitable mechanism to enable extraction of device 200from vessel 205, according to some embodiments of the present inventionFor example, if it is required device 200 may be extracted from vessel205 by using, for example, an extraction hook or wire etc associatedwith catheter 210 or other insertion mechanism to hook onto or otherwiseconnect with device 200 at pullable mechanism 330, and extract device200. Balloons 240 may be dilated before extraction of device 200, andmay optionally be extracted via catheter 210. Further, the extraction ofdevice 200 backwards, against the flow of blood in the vessel may enablerelatively easily disengagement of anchoring mechanisms 310, since thedirection of extraction may be counter the direction of engagement ofanchor mechanisms 310.

Reference is now made to FIG. 3C, wherein a meshed or stent-likemechanism 340 may enclose at least a portion of cap 250 and/or base 260,according to some embodiments of the present invention Stent-likemechanism 340 may be expanded by balloons 240 and/or cap 250, optionallyproviding support to vessel blocking device 200. Stent-like mechanism340 may include one or more anchoring mechanisms 310 for anchoringvessel blocking device 200 into the walls of a vessel when stent-likemechanism 340 is expanded sufficiently. Stent-like mechanism 340 may beconstructed from metal or other suitable materials. Stent-like mechanism340 may be glued or otherwise bonded or connected to cap 250 and/or base260.

Reference is now made to FIG. 3D, which depicts a coil like mechanism350 that may be bonded or otherwise connected to vessel blocking device200. Coil like mechanism 350 may enclose at least a portion of cap 250and/or base 260, according to some embodiments of the present invention.Coil like mechanism 350 may be expanded by for example balloons 240, cap250 and/or base 260, optionally providing support to vessel blockingdevice 200. As can be seen with reference to FIG. 3E, coil-likemechanism 350 may include one or more anchoring mechanisms 310 foranchoring vessel blocking device 200 into the walls of a vessel whenstent-like mechanism 340 is expanded sufficiently. Stent-like mechanism340 may be constructed from metal or other suitable materials

Reference is now made to FIG. 4, which depicts examples 4A-4E ofanchoring mechanisms that lie on a substrate 400, according to someembodiments of the present invention. FIG. 4A depicts straight spikesextending from substrate 400. FIG. 4B depicts cross type spikesextending from substrate 400. FIG. 4C depicts hook-like spikes extendingoutwards from substrate 400. FIG. 4D depicts bent spikes at variousangles extending from substrate 400, for example, enabling criss-crossanchoring. FIG. 4E depicts a plurality of spikes that are “locked on” toeach other, on substrate 400. Other anchoring mechanisms may be used,using spikes, hooks, pins or other suitable bonding elements. Anchoringmechanisms may be arranged in other suitable arrangements, or in anycombination of arrangements. Anchoring mechanisms may be constructedfrom metal, plastic or any other suitable materials.

Reference is now made to FIG. 5A, which depicts a vessel blocking device200, according to some embodiments of the present invention. Vesselblocking device 200 may include, for example, two balloons or pairs ofballoons, for example, 560 and 570, at proximal side and distal siderespectively of cap 250. For example, after inflating both sets ofballoons, gas and/or liquids may be released through catheter 210. Therelease of gas and/or liquids may result in a low or relatively lowpressure area or a vacuum forming between balloons 560 and balloons 570.The pressure may be low relative to for example the surrounding tissue,or the blood pressure in the nearby sections of the vessel. The vacuummay cause the walls 555 of vessel 205 to be sucked inwards, for example,towards cap 250 and/or base 260, until, for example, anchoringmechanisms 310 anchor themselves into the walls 555 of vessel 205. Aftercap 250 and/or base 260 have been anchored to walls 555 the balloons maybe deflated and catheter 210 may be extracted, together with other nonrequired elements of vessel blocking device 200, leaving requiredelements of cap 250 and/or base 260 in vessel 205. Any number or type ofballoons may be used, in any combination.

Reference is now made to FIG. 5B which depicts a vessel blocking device200 being anchored to walls 555 of vessel 205, using hook-type anchoringmechanisms 580. As described above with reference to FIG. 5A, a low orrelatively low pressure area or vacuum may be created in an area ofvessel 205, therefore causing the vessel walls to be forced inwardsuntil engaging with hooks 580. After cap 250 and/or base 260 have beenanchored to walls 555 the balloons may be deflated and the catheter maybe extracted, leaving the cap and/or base 260 in vessel 205. Anycombination of the above steps may be implemented Other steps or seriesof steps may be used.

According to some embodiments of the present invention, a plurality ofballoons may be used to generate internal pressure that may cause avessel to collapse, thereby permanently blocking the vessel. Each of aplurality of vessels may be individually controlled, or may becontrolled in groups. For example, balloons may be inflated and deflatedto enable control over internal pressure of the vessel, anchoring andde-anchoring of vessel blocking device 200 to the vessel walls, or othersuitable functions.

Reference is now made to FIG. 5C, which is a flowchart of a method forblocking vessels, according to an embodiment of the present invention.In block 50 vessel blocking device (e.g., device 200 of FIG. 2 or otherembodiments discussed herein) may be inserted into a vessel (e.g., 205of FIG. 2) by an insertion device, for example from within a catheter(e.g., 210 in FIG. 2), with elements of vessel blocking device 200 beingin a contracted or folded position. Other suitable devices may be used.For example, blocking device 200 may be inserted into a junction of avessel (e.g., 106 of FIG. 1) where a superficial or another vessel is tobe blocked and/or treated. In block 51 one or more balloons (e.g.,balloon 240 of FIG. 2) or other expandable devices may be expanded, forexample inflated, thereby expanding cap and/or base of blocking device(e.g., cap 250 and/or base 260 of blocking device 200 of FIG. 2) towardsthe vessel wall. In other embodiments inflation of, for example, atleast one balloon may create a vacuum or low pressure area in an area ofthe vessel which may cause the vessel walls to be forced inwards untilengaging with vessel blocking device anchoring mechanism (e.g.,anchoring mechanism 310 of blocking device 200 of FIG. 5A) In block 52cap 250 and/or base 260 may continue to be expanded until piercing,colliding, pressuring etc. the vessel wall, to enable anchoring ofvessel blocking device 200 to the vessel wall. In block 53 treatment maybe provided to at least a part of vessel 205, for example,sclerotherapy, ligation and/or other suitable treatments or procedures.In block 54 vessel blocking device (e.g., device 200 of FIG. 2) may bedisconnected from catheter (e.g., catheter 210 of FIG. 2) andunnecessary elements of vessel blocking device 200 and/or other elementsfrom within vessel 205 may be removed together with catheter 210 fromthe patient, leaving required elements of vessel blocking device 200 inplace in vessel 205. Any combination of the above steps may beimplemented. Other steps or series of steps may be used.

Reference is now made to FIG. 6A which is a schematic illustration of avessel blocking device according to some embodiments of the presentinvention. A vessel blocking device may be a collapsible or reversibledevice, for example, which is able to change its shape and to return tothe former shape. Collapsible plug or blocking device 600, which may beconstructed from stainless steel, Nitinol, biodegradable polypropylen,plastic material for use inside blood vessels, or any other suitablematerials, may be delivered in a collapsed or folded state from within adelivery capsule, a catheter or alternative delivery device, forexample, within a guide wire or guide balloon of a catheter etc. Plug600 may be expandable into any suitable shape to fit within a vessel 605(e.g., a varicose vein), and to be substantially lodged between walls ofa vessel at a target location. Fox example, plug 600 in its expandedform may have a ring shape, oval, figure-8 (e.g., FIG. 6B) or anothersuitable shape. Plug 600 may include an interconnected or mesh typearchitecture that is known in the art of stenting. Other suitablearchitectures may be used. Plug 600 may include clasps, fasteners, hooks610 or other suitable locking or catching elements to enable engaging,catching, fastening, dragging or otherwise locking plug 600 to walls ofvessel 605. Hooks 610 may be configured to be directed in multipledirections to enable locking of plug 600 to walls of vessel 605 inmultiple directions and locations. For example, hooks may be configuredlike Velcro™ or other suitable fastening tape, consisting of, forexample, a strip of nylon with a surface of minute hooks that fasten toa corresponding strip with a surface of uncut pile. In one embodiment,hooks 610 may be directed to face left wall 620 and right wall 625 ofvessel 605 (left and right being relative terms, and being used for thepoint of view shown), such that when pressure is applied externally tovessel 605, adjacent to plug 600, hooks 610 may engage both left wall620 and right wall 625, and/or both ceiling and floor of the vessel,thereby fusing the vessel walls together, optionally around plug 600.Hooks may be configured in other directions, to enable sealing of plug600 to vessel 605 at one or more locations.

As can be seen with reference to FIG. 6B, a target area of a vessel, forexample a selected junction in a bifurcated vein, may be blocked byvessel blocking device which may include a plug 660 constructed from amemory material, for example, Nitinol or other suitable materials.Memory plug 660 may be delivered in a collapsed or folded state fromwithin a delivery capsule, a catheter or alternative delivery device,for example, within a guide wire or guide balloon of a catheter etc.Memory plug 660 may be expanded after delivery to a selected area, suchthat the plug may engage the walls of vessel 675. Memory plug 660 mayinclude hooks 670 or other suitable locking or catching elements toenable engaging, catching, or otherwise locking plug 660 to vessel walls675. Hooks 670 may be configured to be directed in one or moredirections to enable locking of plug 660 to walls of vessel 675. Uponengagement of the vessel walls, memory plug 660 may return to apredetermined shape, for example, a flat shape that enables the walls ofthe vessel to be blocked, fused or sealed around plug 660. For example,by applying pressure externally to vessel 675, adjacent to plug 660,hooks 670 may engage vessel walls 675 and may fuse and/or connect vesselwalls together, around plug 660. For example, a doctor or a healthprofessional may press outside the body in proximity to the plug 660location and may cause plug 660 to flatten and/or collapse.

Plug 660 may be constructed from absorbable and/or dissolvable materialswhich may dissolve in the body after a certain period of time which mayincrease the encapsulation in the treatment area, for example, thesaphenofemoral junction area, and may prevent recanalization.

As can be seen with reference to FIG. 6C, plug 600 in its collapsed,folded or pressured state may permanently fasten the walls of vein 605together, optionally joining the walls by being fused to plug 600,thereby providing a sealed zone or area in which treatment may beapplied. An outside pressure may be applied to plug 600 when it isplaced in the preferred position in the vessel and may result inengagement and/or collapsing of the vessel walls towards plug 600, byfor example, hooks or other anchoring mechanism. This may enableblocking or occluding of a vessel. Plug 600 may be naturally expandable,collapsible, may be a memory shape material, or may have other suitableshapes and/or designs to enable forming of a sealed zone in a vessel.

Reference is now made to FIG. 6D, which is a flowchart of a method forblocking vessels using collapsible plug or blocking device, according toan embodiment of the present invention. In block 60, a plug incollapsed, minimized or shrunken form may be delivered to a selectedlocation using, for example, a delivery catheter, and optionally usingultrasonic scanning to determine the selected location. In block 61 theplug may be expanded, for example, using a balloon or other suitablemechanisms. In block 62 pressure may be applied externally to the vesselat the area which is in proximity to the selected location to allowengagement of the locking mechanisms to the vessel walls. In block 63hooks or other locking mechanisms may engage the vessel walls by fusingthe vessel walls together, optionally around the plug. For example,locking mechanisms may anchor and/or connect the blocking plug to thevessel wall and external pressure may change the shape of the plug andmay create an obstruction of the vessel. In block 64 the externalpressure may be released. In block 65 the plug may be permanentlycollapsed to provide a seal or a block at the selected location in thevessel In block 66 the vessel blockage may be verified, for example,using ultrasonic scanning or any other verifying technique. In block 67treatment may be applied to the treatment area, which may be defined bythe positioning of the plug. Other steps and series of steps, may beused, and certain steps may be omitted.

Once the selected vessel or junction has been blocked, the vesselupstream of the blockage may be treated. For example, device 200 of FIG.2 and/or other suitable devices may be used to ligate the segment whilesignificantly limiting the risk of embolic damage, and optionally whileinflicting minimal trauma to the surrounding tissue. Additionally oralternatively a sclerosing agent may be delivered to the segment distalto the ligation, using for example a drug catheter. The agent deliverymay be done while suction of blood through catheter 210 to generate zeropressure. The zero pressure may prevent the sclerosing agent topenetrate other vessel. Such a sclerosing agent or other suitable agentsmay be dispersed at the distal tip 220 of device 200 or at othersuitable locations. Other steps or series of steps may be used

Reference is now made to FIG. 7A which is a schematic illustration of apressure control mechanism according to an embodiment of the presentinvention. After insertion of plug or blocking device 760 into vessel205 a treatment area 720 may exist between the blocking device 760 andthe distal tip of catheter 710. Delivery of a sclerosing or othersuitable agent into a vessel may cause increased pressure withintreatment area 720. Sclerosing or other suitable agent may be deliveredinto treatment area 720 through a small diameter catheter 730 or othersuitable device which may be inserted through catheter 710 port 751 andmay reach the distal end 755 of catheter 710. Increased pressure may,for example, enable the sclerosing agent to penetrate tributaries of thevein or other undesired locations, thereby entering the blood stream ofthe patient. Internal vein pressure may be controlled using a suctiondevice to selectively remove contents from the vein. For example,suction device or port 750, which may be, for example, a syringe,suction pump, balloon device or other suitable devices which may be usedto draw or pump out contents, for example blood, from around the distalend 755 of catheter 710, to reduce the pressure in treatment area 720.In one embodiment suction device 750 may be operated synchronously withthe delivery of sclerosing agent through, for example, port 751 andinner catheter 730, to remove a similar quantity of contents as in beinginfused, thereby maintaining the pressure in treatment area 720. Inother embodiments suction 750 may be used to maintain minimal, low, orzero pressure in treatment area 720, to reduce the entry of sclerosingagents into the blood stream, external to treatment area 720. Further,other steps or series of steps may be used.

Reference is now made to FIG. 7B, which is a flowchart describing amethod for blocking vessels and providing treatment to vessels,according to an embodiment of the present invention. In block 70, a plugor blocking device in collapsed form may be delivered to a selectedlocation using, for example, a delivery catheter. Ultrasonic scanningmay be used to determine the selected location, and to monitor thedelivery of the plug to the selected location. In block 71 the plug orblocking device may be deployed, for example expanded, using a balloonor other suitable mechanisms, for example by radial forces restrained inthe collapsed form, to block the selected vessel (as described in detailabove). In block 72 treatment may be applied to the treatment area,which may be defined by the positioning of the plug. For example,sclerosing or other agents may be dispensed to close the selectedvessel, for example, sclerosing agents may be inserted into the blockedarea through a catheter. In block 73 a suction device (e.g., suctiondevice 750 of FIG. 7A) may draw contents, for example blood from avessel, fox example, adjacent to the distal end 755 of catheter 710 ofFIG. 7A. The suction may enable for example control of the pressureinside the treatment area. For example, suction device (e.g., suctiondevice 750 of FIG. 7A) may be operated synchronously with the deliveryof sclerosing agent to remove a similar quantity of contents as in beinginfused, thereby maintaining the pressure in treatment area (e.g.,treatment area 720 of FIG. 7A). In other embodiments, reduction inpressure, for example, suction may be used to maintain minimal, low, orzero pressure in treatment area, to reduce the entry of sclerosingagents into the blood stream, external to treatment area. In block 74the catheter and the various components that are not intended to remainin the vessel may be pulled out of the vessel. The plug, together withthe sclerosing agents may be left in the vessel, to destroy or close theunwanted vessel, and to seal off the vessel such that the sclerosingagent cannot flow though the vessel into the blood stream. Further,other steps or series of steps may be used.

Reference is now made to FIG. 7C, which is a schematic illustration of apressure reducing device according to some embodiments of the presentinvention. Delivering, of a sclerosing or other suitable agent into avessel may cause increased pressure within a treatment area (e.g.,treatment area 720 of FIG. 7A). Increased pressure may, for example,enable the sclerosing agent to penetrate tributaries of the vein orother undesired locations, thereby entering the blood stream of thepatient. A pressure reducing device 770, which may include, for example,one or more expandable/collapsible balloons 775, may be used to pushand/or pull out contents, for example blood, from vein/vessel 702, toreduce the pressure in treatment area 720. For example, balloon(s) maybe pulled out of vessel by extracting catheter 710 from vessel 702. Inone embodiment pressure reducing device 770 may be operatedsynchronously with the delivery of sclerosing agent, to remove a similarquantity of contents as in being infused, thereby maintaining thepressure in treatment area 720. In other embodiments pressure reducingdevice 770 may be used to maintain minimal, low, or zero pressure intreatment area 720, to reduce the entry of sclerosing agents into theblood stream, external to treatment area 720.

Reference is made to FIG. 8, which schematically illustrates atransverse view of an intraluminal vessel occluding stent or blockingdevice 800 according to an embodiment of the present invention.Occluding stent 800 may be inserted, for example, into a target vessel805 that requires treatment, for example, a safenus vein, a bifurcatedvessel or an occluded blood segment that is to be blocked and/orotherwise treated, or the saphenofemoral junction area 845 between adeep vein 843 and safenus vein 805. Other suitable areas may be treated.The target vessel 805 may be connected to another vessel, for example,as the safenus vein is connected to the deep vein by plurality ofperfurant veins 842. Such insertion of occluding stent 800 may beimplemented, for example, using an insertion device, for example,catheter 810, which may include a guidewire 830, to help guide occludingstent 800 to a selected location Occluding stent 800 may be insertedinto vessel 805 through catheter 810 in its compact, collapsed orminimized form or shape. After catheter 810 is positioned in thetreatment area occluding stent 800 may be released into the vessel by acatheter 810 pusher, or additional catheter 835, which may be a thinnerlumen catheter relative to catheter 810 and may be inserted insidecatheter 810 lumen (not shown). When occluding stent 800 is out ofcatheter 810 it may expend towards the vessel walls and may change itsshape. Other insertion devices and methods may be used.

Catheter 835 may include for example a chug dispensing mechanism 825, toenable delivery of a pharmaceutical compound, medication or agent,herein referred to as a sclerosing agent, to a target area. Catheter 810may include a distal tip 820 which may be located in proximity to theblocking area Vessel occluding stent or blocking device 800 may beexpandable into an hourglass shape, or into the shape of two cones 805and 806 or other concave, bowl or hemispherical shaped devices,typically connected or attached at their narrow ends to fit withinvessel 805 (e.g., a varicose vein), and to substantially be lodgedbetween walls of a vessel at a target location. Other shapes may beused. For example, vessel occluding stent 800 in its expanded form mayhave the shape of two cones, where the upper cone may prevent blood frompenetrating the treatment area 833 while the lower cone may preventsclerosing agents from entering into the blood stream, external totreatment area 8.33. Upper and lower are relative terms when usedherein; lower generally means in proximity to the insertion deviceinsertion point. Vessel occluding stent 800 may include aninterconnected or mesh type architecture that is known in the art ofstenting. Other suitable architectures may be used. Vessel occludingstent 800 may be constructed from stainless steel, graft, film, Nitinol,biodegradable polypropylen, plastic material for use inside bloodvessels, or other suitable materials. Vessel occluding stent 800 may beconstructed from absorbable and/or dissolvable materials which maydissolve in the body after a certain period of time and may increase theencapsulation in the treatment area, for example, the saphenofemoraljunction area 845, and may prevent recanalization. Vessel occludingstent 800 may be delivered in a collapsed state from within a deliverycapsule or alternative delivery device, for example, within a guide wireor guide balloon of a catheter etc.

Vessel occluding stent 800 may include clasps, fasteners, hooks 811and/or 812 or other suitable locking or catching elements to enableengaging, catching, fastening, dragging or otherwise locking vesseloccluding stent 800 to vessel walls 805. Hooks 811 and/or 812 may beconfigured to be directed in multiple directions to enable locking ofvessel occluding stent 800 to walls of vessel 805 in multiple directionsand locations. For example, hooks may be configured like Velcro™ orother suitable fastening tape, consisting of, for example, a strip ofnylon with a surface of minute hooks that fasten to a correspondingstrip with a surface of uncut pile. Hooks may be configured in otherdirections, to enable sealing of vessel occluding stent 800 to vessel805 at one or more locations. Other fastening or fixing methods may beused.

Vessel occluding stent 800 may include floss or a wire 840, for example,a medical suture type which may be absorbable and may dissolve in thebody after a limited period of time. For example, the suture may be madeof biocompatible material. Wire 840 may be coated with occluding agent,for example, fibrin, sclerosant or any other suitable occludingmaterial. Wire 840 may be connected to the lower cone 806 of vesseloccluding stent 800 or to any other point of vessel occluding stent 800and may come out of port 816 of catheter 810 or may be released whilepulling of catheter 810 pusher or catheter 835 out of catheter 810. Wire840 may be used to guide and lead device 800 to a selected location.Wire 840 may be used to prevent migration or movement of vesseloccluding stent 800 inside vessel 805 until hooking mechanism 811 and/or812 is engaged with vessels walls 805. In addition wire 840 may be usedin emergency situation for pulling the vessel occluding stent 800 out ofvessel 805.

After insertion of vessel occluding stent 800 into vessel 805 atreatment area 833 may exist between the occluding stent 800 and thedistal tip 820 of catheter 810. Delivering of a sclerosing or othersuitable agent into a vessel while pulling out catheter 810 and/orcatheter 835 may cause increased pressure within treatment area 833.Sclerosing or other suitable agent may be delivered into treatment area833 through a catheter 835 or other suitable device which may beinserted through port 825 and may reach the distal end 820 of catheter810 and treatment area 833. Increased pressure may, for example, enablethe sclerosing agent to penetrate tributaries of the vein or otherundesired locations, thereby entering the blood stream of the patient,for example, via perforant veins 842. Internal vein pressure may becontrolled using a suction device to selectively remove contents fromthe vein. For example, suction device or port 815, which may be, forexample, a syringe, suction pump, balloon device or other suitabledevices which may be used to draw or pump out contents, for exampleblood, from around the distal end 820 of catheter 810, to reduce thepressure in treatment area 833. In one embodiment suction device 815 maybe operated synchronously with the delivery of sclerosing agent through,for example, port 815 and inner catheter 835, to remove a similarquantity of contents as in being infused, thereby maintaining thepressure in treatment area 833. In other embodiments controlling thepressure in the treatment area may include reduction in pressure in thetreatment area, for example, suction 815 may be used to maintainminimal, low, or zero pressure in treatment area 833, to reduce theentry of sclerosing agents into the blood stream, external to treatmentarea 833. Further, other steps or series of steps may be used.

According to some embodiments of the present invention, after extractingcatheter (e.g., catheter 210 of FIG. 2) or other input device from avessel (e.g., vessel 205 of FIG. 2), a hole may be left by theextraction of catheter guidewire (e.g., guidewire 230 of FIG. 2). Such ahole, gap or opening, etc., may be partially or completely blocked, forexample, using a plug or other suitable blocking element to enable cap(e.g., cap 250 of FIG. 2) to seal vessel 205

Although some embodiments of the invention described above may refer toan intraluminal device configured for vessel ligation, it will beappreciated by those skilled in the art that the intraluminal deviceaccording to other embodiments of the invention may be configured forligating other bifurcated lumen, artery or vessel, e.g., in thevascular, biliary, genitourinary, gastrointestinal, nervous andrespiratory systems, which may have narrowed, weakened, distorted, orotherwise deformed structures. Other lumens may be blocked.

The foregoing description of the embodiments of the invention has beenpresented for the purposes of illustration and description. It is notintended to be exhaustive or to limit the invention to the precise formdisclosed. It should be appreciated by persons skilled in the art thatmany modifications, variations, substitutions, changes, and equivalentsare possible in light of the above teaching It is, therefore, to beunderstood that the appended claims are intended to cover all suchmodifications and changes as fall within the true spirit of theinvention.

1. A vessel blocking device comprising: an expandable cap to block a vessel; and a base to stabilize the cap in a vessel.
 2. The device of claim 1, comprising an expansion element disposed between the cap and the base.
 3. The device of claim 1, comprising an inflatable balloon disposed between the cap and the base.
 4. The device of claim 3, wherein the cap partially surrounds the balloon.
 5. The device of claim 3, wherein the base partially surrounds the balloon.
 6. The device of claim 3, wherein the blocking device is located at the distal tip of an insertion device, and the cap is distal to the insertion device relative to the cap, the balloon being disposed between the cap and the base.
 7. The device of claim 1, wherein the cap is concave, and wherein the cap is expandable so that a rim of the cap can extend outwards towards vessel walls.
 8. The device of claim 1, wherein the base is expandable outwards towards vessel walls.
 9. The device of claim 1, wherein an increase in pressure in the inner portion of the cap causes the cap to expand outwards towards the vessel walls.
 10. The device of claim 9, wherein pressure is provided by balloon inflation.
 11. The device of claim 1, wherein pressure stored within the cap causes the cap to expand outwards towards the vessel walls.
 12. The device of claim 11, wherein pressure is provided by a stent like mechanism.
 13. The device of claim 11, wherein pressure is provided by a coil like mechanism.
 14. The device of claim 1, wherein the base comprises an anchoring mechanism to anchor the cap to the vessel walls.
 15. The device of claim 14, wherein anchoring mechanism comprises spikes.
 16. The device of claim 14, wherein anchoring mechanism comprises hooks
 17. The device of claim 1, comprising a pullable mechanism to extract the blocking device from a vessel.
 18. The device of claim 1, comprising an absorbable wire.
 19. The device of claim 18, wherein the absorbable wire is coated with occluding agent.
 20. The device of claim 1, comprising a catheter device.
 21. The catheter device of claim 20, comprising a guidewire.
 22. The catheter device of claim 20, comprising a drug dispensing mechanism.
 23. The catheter device of claim 20, comprising a channel for remotely inflating and deflating the balloon.
 24. The device of claim 1, wherein the base is cap shaped.
 25. A vessel blocking device comprising: two concave blocking devices, connected at their narrow ends; and an anchoring mechanism.
 26. The device of claim 25, wherein the vessel blocking device is foldable.
 27. The device of claim 25, wherein the vessel blocking device has an hourglass shape.
 28. The device of claim 25, wherein the concave devices each include a rim, the rim being expandable towards a vessel.
 29. The device of claim 25, comprising an expansion element to expand a blocking device towards a vessel.
 30. The device of claim 25, comprising a pullable mechanism to extract the expandable vessel blocking device from a vessel.
 31. The device of claim 25, comprising an absorbable wire.
 32. The device of claim 31, wherein the absorbable wire is coated with occluding agent.
 33. The device of claim 25, wherein the anchoring mechanism comprises spikes.
 34. The device of claim 25, wherein the anchoring mechanism comprises hooks.
 35. The device of claim 25, comprising a catheter device.
 36. The catheter device of claim 35, comprising a guidewire.
 37. The catheter device of claim 35, comprising a drug dispensing mechanism
 38. The catheter device of claim 35, comprising an inner catheter device
 39. A treatment method comprising: inserting a blocking device into a target vessel, deploying the blocking device to block a treatment area and delivering an occluding agent to the treatment area while controlling pressure in the treatment area.
 40. The method of claim 39, wherein inserting a blocking device includes using an insertion device.
 41. The method of claim 40, wherein the insertion device is a catheter.
 42. The method of claim 40, wherein the insertion device is a capsule.
 43. The method of claim 39, wherein deploying the blocking device comprises expanding the blocking device to fit vessel walls.
 44. The method of claim 39, wherein deploying the blocking device includes anchoring the blocking device to the vessel walls.
 45. The method of claim 39, wherein deploying the blocking device comprises applying external pressure to the vessel walls to engage the blocking device to the vessel walls.
 46. The method of claim 39, wherein deploying the blocking device includes using an absorbable wire to guide and hold the blocking device to a selected location
 47. The method of claim 40 comprising disconnecting and removing unnecessary elements from the vessel using the insertion device.
 48. The method of claim 39, wherein an occluding agent is a sclerosing agent.
 49. The method of claim 39 comprising delivering of an occluding agent using a catheter.
 50. The method of claim 39 comprising controlling pressure in the treatment area using suction of content from treatment area.
 51. The method of claim 39 comprising controlling pressure in the treatment area by reduction of pressure in the treatment area.
 52. The method of claim 50, wherein the suction of content from treatment area is per formed using a suction device.
 53. The method of claim 52, wherein the suction device is a pump.
 54. The method of claim 52, wherein the suction device is a balloon.
 55. The method of claim 52, wherein the suction device is a syringe.
 56. The method of claim 50 comprising controlling pressure in the treatment area using suction of content from treatment area while delivering an agent to the treatment area.
 57. The method of claim 39, wherein controlling pressure in the treatment area includes maintaining the pressure in treatment area.
 58. The method of claim 57 comprising maintaining zero pressure in the treatment area
 59. The method of claim 57, wherein controlling pressure in the treatment area comprises reducing entry of sclerosing agents into the blood stream, external to the treatment area.
 60. The method of claim 39 comprising using as a blocking device two caps connected at their narrow ends.
 61. The method of claim 39 comprising using an expandable ring shaped blocking device.
 62. The method of claim 39 comprising using an expandable figure-8 shaped blocking device.
 63. The method of claim 39 comprising using an expandable oval shaped blocking device. 